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This chapter presents a 1997 commentary on the extracorporeal membrane oxygenation (ECMO) trial for neonates with respiratory failure. The ECMO experiences shows that there are significant national differences in the factors and dynamics that come into play in the spread of high-cost, high-tech, high-risk modern interventions in medicine. It addresses the question: How can we balance the technical challenge of perfecting hardware for life-support against medicine's humane imperative to avoid needless pain and suffering?

This chapter presents a 1997 commentary on the extracorporeal membrane oxygenation (ECMO) trial for neonates with respiratory failure. The ECMO experiences shows that there are significant national differences in the factors and dynamics that come into play in the spread of high-cost, high-tech, high-risk modern interventions in medicine. It addresses the question: How can we balance the technical challenge of perfecting hardware for life-support against medicine's humane imperative to avoid needless pain and suffering?